Skip to main content

Advertisement

SpringerLink
Log in

Effects of Psychological Stress on Vascular Physiology: Beyond the Current Imaging Signal

  • Nuclear Cardiology (V Dilsizian, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review describes the effects of psychological stress on the physiology of the entire vascular system, from individual cellular components to macrovascular and microvascular responses, and highlights the importance of the vascular system in the context of current limitations in cardiac imaging for evaluation of the cardiovascular response to mental stress.

Recent Findings

The physiological responses that mediate vascular changes are based on evolutionary needs, but there is increasing evidence that the long-term consequences of psychological stress can precipitate the development and progression of cardiovascular disease (CVD). While there is an extensive body of literature describing localized physiological responses or overt cardiovascular manifestations, often framed within the organ-specific scope of cardiovascular imaging, there has not been a comprehensive description of the global vascular effects of psychological stress. Given the global nature of these processes, targeted cardiovascular imaging modalities may be insufficient. Here we approach the vascular response to mental stress systematically, describing the effects on the endothelium, vascular smooth muscle, and adventitia. We then address the mental stress effects on large vessels and the microvascular compartment, with a discussion of the role of microvascular resistance in the pathophysiology of mental stress-induced myocardial ischemia.

Summary

Vascular responses to psychological stress involve complex physiological processes that are not fully characterized by routine cardiovascular imaging assessments. Future research incorporating standardized psychological assessments targeted toward vascular mechanisms of stress responses is required to guide the development of behavioral and therapeutic interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338(3):171–9.

    CAS  PubMed  Google Scholar 

  2. McEwen BS, Stellar E. Stress and the individual. Mechanisms leading to disease. Arch Intern Med. 1993;153(18):2093–101.

    CAS  PubMed  Google Scholar 

  3. Ulrich-Lai YM, Herman JP. Neural regulation of endocrine and autonomic stress responses. Nat Rev Neurosci. 2009;10(6):397–409.

    CAS  PubMed  Google Scholar 

  4. Rosengren A, Hawken S, Ôunpuu S, Sliwa K, Zubaid M, Almahmeed WA, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):953–62.

    PubMed  Google Scholar 

  5. Hammadah M, Kim JH, Al Mheid I, et al. Coronary and peripheral vasomotor responses to mental stress. J Am Heart Assoc. 2018;7(10):e008532.

  6. Strike PC, Steptoe A. Systematic review of mental stress-induced myocardial ischaemia. Eur Heart J. 2003;24(8):690–703.

    CAS  PubMed  Google Scholar 

  7. Bairey CN, Krantz DS, Rozanski A. Mental stress as an acute trigger of ischemic left ventricular dysfunction and blood pressure elevation in coronary artery disease. Am J Cardiol. 1990;66(16):28G–31G.

    CAS  PubMed  Google Scholar 

  8. Burg MM, Jain D, Soufer R, Kerns RD, Zaret BL. Role of behavioral and psychological factors in mental stress-induced silent left ventricular dysfunction in coronary artery disease. J Am Coll Cardiol. 1993;22(2):440–8.

    CAS  PubMed  Google Scholar 

  9. Arrighi JA, Burg M, Cohen IS, Soufer R. Simultaneous assessment of myocardial perfusion and function during mental stress in patients with chronic coronary artery disease. J Nucl Cardiol. 2003;10(3):267–74.

    PubMed  Google Scholar 

  10. Hasdai D, Gibbons RJ, Holmes DR Jr, Higano ST, Lerman A. Coronary endothelial dysfunction in humans is associated with myocardial perfusion defects. Circulation. 1997;96(10):3390–5.

    CAS  PubMed  Google Scholar 

  11. Campisi R, Czernin J, Schöder H, Sayre JW, Schelbert HR. L-arginine normalizes coronary vasomotion in long-term smokers. Circulation. 1999;99(4):491–7.

    CAS  PubMed  Google Scholar 

  12. Boyle SH, Matson WR, Velazquez EJ, Samad Z, Williams RB Jr, Sharma S, et al. Metabolomics analysis reveals insights into biochemical mechanisms of mental stress-induced left ventricular dysfunction. Metabolomics. 2015;11(3):571–82.

    CAS  PubMed  Google Scholar 

  13. Jiang W, Samad Z, Boyle S, Becker RC, Williams R, Kuhn C, et al. Prevalence and clinical characteristics of mental stress-induced myocardial ischemia in patients with coronary heart disease. J Am Coll Cardiol. 2013;61(7):714–22.

    PubMed  Google Scholar 

  14. Andrews TC, Parker JD, Jacobs S, Friedman R, Cummings N, MacCallum G, et al. Effects of therapy with nifedipine GITS or atenolol on mental stress-induced ischemic left ventricular dysfunction. J Am Coll Cardiol. 1998;32(6):1680–6.

    CAS  PubMed  Google Scholar 

  15. Hilenski LL, Griendling KK. Vascular smooth muscle. In Creager MA, Beckman JA, Loscalzo J (eds). Vascular Medicine: A Companion to Braunwald's Heart Disease, 3rd Ed. 2013, 32–63. Elsevier, San Diego, CA.

  16. Kinlay S, Libby P, Ganz P. Endothelial function and coronary artery disease. Curr Opin Lipidol. 2001;12(4):383–9.

    CAS  PubMed  Google Scholar 

  17. Creager MA, Lüscher TF, prepared with the assistance of, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part I. Circulation. 2003;108(12):1527–32.

    PubMed  Google Scholar 

  18. Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation. 2004;109(23 Suppl 1):III27–32.

    PubMed  Google Scholar 

  19. Moncada S, Higgs A. The L-arginine-nitric oxide pathway. N Engl J Med. 1993;329(27):2002–12.

    CAS  PubMed  Google Scholar 

  20. Broten TP, et al. Role of endothelium-derived relaxing factor in parasympathetic coronary vasodilation. Am J Phys. 1992;262(5 Pt 2):H1579–84.

    CAS  Google Scholar 

  21. Yanagisawa M, Kurihara H, Kimura S, Goto K, Masaki T. A novel peptide vasoconstrictor, endothelin, is produced by vascular endothelium and modulates smooth muscle Ca2+ channels. J Hypertens Suppl. 1988;6(4):S188–91.

    CAS  PubMed  Google Scholar 

  22. Drexler HG. Responsiveness of B-cll cells to growth factors. Blood. 1988;72(4):1435–6.

    CAS  PubMed  Google Scholar 

  23. Inoue A, Yanagisawa M, Kimura S, Kasuya Y, Miyauchi T, Goto K, et al. The human endothelin family: three structurally and pharmacologically distinct isopeptides predicted by three separate genes. Proc Natl Acad Sci U S A. 1989;86(8):2863–7.

    CAS  PubMed  Google Scholar 

  24. Winkles JA, Alberts GF, Brogi E, Libby P. Endothelin-1 and endothelin receptor mRNA expression in normal and atherosclerotic human arteries. Biochem Biophys Res Commun. 1993;191(3):1081–8.

    CAS  PubMed  Google Scholar 

  25. Kinlay S, Behrendt D, Wainstein M, Beltrame J, Fang JC, Creager MA, et al. Role of endothelin-1 in the active constriction of human atherosclerotic coronary arteries. Circulation. 2001;104(10):1114–8.

    CAS  PubMed  Google Scholar 

  26. Strawn WB, Bondjers G, Kaplan JR, Manuck SB, Schwenke DC, Hansson GK, et al. Endothelial dysfunction in response to psychosocial stress in monkeys. Circ Res. 1991;68(5):1270–9.

    CAS  PubMed  Google Scholar 

  27. Spicer J, Shimbo D, Johnston N, Harlapur M, Purdie-Vaughns V, Cook J, et al. Prevention of stress-provoked endothelial injury by values affirmation: a proof of principle study. Ann Behav Med. 2016;50(3):471–9.

    PubMed  Google Scholar 

  28. Shimbo D, Rosenberg LB, Chaplin W, Zhao S, Goldensohn ER, Cholankeril M, et al. Endothelial cell activation, reduced endothelial cell reparative capacity, and impaired endothelial-dependent vasodilation after anger provocation. Int J Cardiol. 2013;167(3):1064–5.

    Google Scholar 

  29. Custodis F, Gertz K, Balkaya M, Prinz V, Mathar I, Stamm C, et al. Heart rate contributes to the vascular effects of chronic mental stress: effects on endothelial function and ischemic brain injury in mice. Stroke. 2011;42(6):1742–9.

    CAS  PubMed  Google Scholar 

  30. Chung IM, Kim YM, Yoo MH, Shin MK, Kim CK, Suh SH. Immobilization stress induces endothelial dysfunction by oxidative stress via the activation of the angiotensin II/its type I receptor pathway. Atherosclerosis. 2010;213(1):109–14.

    CAS  PubMed  Google Scholar 

  31. Spieker LE, Hürlimann D, Ruschitzka F, Corti R, Enseleit F, Shaw S, et al. Mental stress induces prolonged endothelial dysfunction via endothelin-A receptors. Circulation. 2002;105(24):2817–20.

    CAS  PubMed  Google Scholar 

  32. Sherwood A, Johnson K, Blumenthal JA, Hinderliter AL. Endothelial function and hemodynamic responses during mental stress. Psychosom Med. 1999;61(3):365–70.

    CAS  PubMed  Google Scholar 

  33. Ghiadoni L, et al. Mental stress induces transient endothelial dysfunction in humans. Circulation. 2000;102(20):2473–8 This study demonstrated that healthy men exposed to psychological stress with a public speaking task rapidly develop endothelial dysfunction as measured by reduced brachial artery flow-mediated dilation, and this persists for up to four hours.

    CAS  PubMed  Google Scholar 

  34. Laine P, Naukkarinen A, Heikkila L, Penttila A, Kovanen PT. Adventitial mast cells connect with sensory nerve fibers in atherosclerotic coronary arteries. Circulation. 2000;101(14):1665–9.

    CAS  Google Scholar 

  35. Alevizos M, Karagkouni A, Panagiotidou S, Vasiadi M, Theoharides TC. Stress triggers coronary mast cells leading to cardiac events. Ann Allergy Asthma Immunol. 2014;112(4):309–16.

    CAS  PubMed  Google Scholar 

  36. Soufer R, Jain H, Yoon AJ. Heart-brain interactions in mental stress-induced myocardial ischemia. Curr Cardiol Rep. 2009;11(2):133–40.

    PubMed  Google Scholar 

  37. Freyschuss U, et al. Cardiovascular and sympathoadrenal responses to mental stress: influence of beta-blockade. Am J Phys. 1988;255(6 Pt 2):H1443–51.

    CAS  Google Scholar 

  38. Greaney JL, Surachman A, Saunders EFH, Alexander LM, Almeida DM. Greater daily psychosocial stress exposure is associated with increased norepinephrine-induced vasoconstriction in young adults. J Am Heart Assoc. 2020;9(9):e015697.

    CAS  PubMed  Google Scholar 

  39. Alkhoder A, et al. Abstract 17559: Norepinephrine levels are associated with the magnitude of vasoconstriction during mental stress. Circulation. 2015;132(suppl_3):A17559-A17559.

    Google Scholar 

  40. Habib KE, Gold PW, Chrousos GP. Neuroendocrinology of stress. Endocrinol Metab Clin N Am. 2001;30(3):695–728 vii-viii.

    CAS  Google Scholar 

  41. Jamieson PM, Li C, Kukura C, Vaughan J, Vale W. Urocortin 3 modulates the neuroendocrine stress response and is regulated in rat amygdala and hypothalamus by stress and glucocorticoids. Endocrinology. 2006;147(10):4578–88.

    CAS  PubMed  Google Scholar 

  42. Hashimoto K, Nishiyama M, Tanaka Y, Noguchi T, Asaba K, Hossein PN, et al. Urocortins and corticotropin releasing factor type 2 receptors in the hypothalamus and the cardiovascular system. Peptides. 2004;25(10):1711–21.

    CAS  PubMed  Google Scholar 

  43. Kalsner S, Richards R. Coronary arteries of cardiac patients are hyperreactive and contain stores of amines: a mechanism for coronary spasm. Science. 1984;223(4643):1435–7.

    CAS  PubMed  Google Scholar 

  44. Allen S, Dashwood M, Morrison K, Yacoub M. Differential leukotriene constrictor responses in human atherosclerotic coronary arteries. Circulation. 1998;97(24):2406–13.

    CAS  PubMed  Google Scholar 

  45. Lytinas M, Kempuraj D, Huang M, Boucher W, Esposito P, Theoharides TC. Acute stress results in skin corticotropin-releasing hormone secretion, mast cell activation and vascular permeability, an effect mimicked by intradermal corticotropin-releasing hormone and inhibited by histamine-1 receptor antagonists. Int Arch Allergy Immunol. 2003;130(3):224–31.

    CAS  PubMed  Google Scholar 

  46. Singh LK, Boucher W, Pang X, Letourneau R, Seretakis D, Green M, et al. Potent mast cell degranulation and vascular permeability triggered by urocortin through activation of corticotropin-releasing hormone receptors. J Pharmacol Exp Ther. 1999;288(3):1349–56.

    CAS  PubMed  Google Scholar 

  47. Arck PC, Slominski A, Theoharides TC, Peters EMJ, Paus R. Neuroimmunology of stress: skin takes center stage. J Invest Dermatol. 2006;126(8):1697–704.

    CAS  PubMed  Google Scholar 

  48. Vanuytsel T, van Wanrooy S, Vanheel H, Vanormelingen C, Verschueren S, Houben E, et al. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut. 2014;63(8):1293–9.

    CAS  PubMed  Google Scholar 

  49. Lagraauw HM, Wezel A, van der Velden D, Kuiper J, Bot I. Stress-induced mast cell activation contributes to atherosclerotic plaque destabilization. Sci Rep. 2019;9(1):2134.

    PubMed  Google Scholar 

  50. Laine P, Kaartinen M, Penttilä A, Panula P, Paavonen T, Kovanen PT. Association between myocardial infarction and the mast cells in the adventitia of the infarct-related coronary artery. Circulation. 1999;99(3):361–9.

    CAS  PubMed  Google Scholar 

  51. Bot I, de Jager SCA, Bot M, van Heiningen SH, de Groot P, Veldhuizen RW, et al. The neuropeptide substance P mediates adventitial mast cell activation and induces intraplaque hemorrhage in advanced atherosclerosis. Circ Res. 2010;106(1):89–92.

    CAS  PubMed  Google Scholar 

  52. Tracey KJ. Physiology and immunology of the cholinergic antiinflammatory pathway. J Clin Invest. 2007;117(2):289–96.

    CAS  PubMed  Google Scholar 

  53. Steptoe A, et al. Acute mental stress elicits delayed increases in circulating inflammatory cytokine levels. Clin Sci (Lond). 2001;101(2):185–92.

    CAS  Google Scholar 

  54. Black PH, Garbutt LD. Stress, inflammation and cardiovascular disease. J Psychosom Res. 2002;52(1):1–23.

    PubMed  Google Scholar 

  55. Altavilla D, Guarini S, Bitto A, Mioni C, Giuliani D, Bigiani A, et al. Activation of the cholinergic anti-inflammatory pathway reduces NF-kappab activation, blunts TNF-alpha production, and protects againts splanchic artery occlusion shock. Shock. 2006;25(5):500–6.

    CAS  PubMed  Google Scholar 

  56. Heinz A, Hermann D, Smolka MN, Rieks M, Gräf KJ, Pöhlau D, et al. Effects of acute psychological stress on adhesion molecules, interleukins and sex hormones: implications for coronary heart disease. Psychopharmacology. 2003;165(2):111–7.

    CAS  PubMed  Google Scholar 

  57. Demirtas T, et al. The link between unpredictable chronic mild stress model for depression and vascular inflammation? Inflammation. 2014;37(5):1432–8.

    CAS  PubMed  Google Scholar 

  58. d'Audiffret AC, et al. Depressive behavior and vascular dysfunction: a link between clinical depression and vascular disease? J Appl Physiol (1985). 2010;108(5):1041–51.

    CAS  Google Scholar 

  59. Gu HF, Tang CK, Yang YZ. Psychological stress, immune response, and atherosclerosis. Atherosclerosis. 2012;223(1):69–77.

    CAS  PubMed  Google Scholar 

  60. Huang CJ, et al. Cardiovascular reactivity, stress, and physical activity. Front Physiol. 2013;4:314.

    PubMed  Google Scholar 

  61. Chida Y, Steptoe A. Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: a meta-analysis of prospective evidence. Hypertension. 2010;55(4):1026–32.

    CAS  PubMed  Google Scholar 

  62. Astrand PO, et al. Cardiac output during submaximal and maximal work. J Appl Physiol. 1964;19:268–74.

    CAS  PubMed  Google Scholar 

  63. Sherwood A, Allen MT, Obrist PA, Langer AW. Evaluation of beta-adrenergic influences on cardiovascular and metabolic adjustments to physical and psychological stress. Psychophysiology. 1986;23(1):89–104.

    CAS  PubMed  Google Scholar 

  64. Obrist PA, Light KC. Comments on “carotid dP/dt as a psychophysiological index of sympathetic myocardial effects: some considerations”. Psychophysiology. 1980;17(5):495–8.

    CAS  PubMed  Google Scholar 

  65. Sherwood A, Turner JR. Hemodynamic responses during psychological stress: implications for studying disease processes. Int J Behav Med. 1995;2(3):193–218.

    CAS  PubMed  Google Scholar 

  66. Jain D, Shaker SM, Burg M, Wackers FJT, Soufer R, Zaret BL. Effects of mental stress on left ventricular and peripheral vascular performance in patients with coronary artery disease. J Am Coll Cardiol. 1998;31(6):1314–22.

    CAS  PubMed  Google Scholar 

  67. Becker LC, Pepine CJ, Bonsall R, Cohen JD, Goldberg AD, Coghlan C, et al. Left ventricular, peripheral vascular, and neurohumoral responses to mental stress in normal middle-aged men and women. Reference group for the psychophysiological investigations of myocardial ischemia (PIMI) study. Circulation. 1996;94(11):2768–77.

    CAS  PubMed  Google Scholar 

  68. Sherwood A, May CW, Siegel WC, Blumenthal JA. Ethnic differences in hemodynamic responses to stress in hypertensive men and women. Am J Hypertens. 1995;8(6):552–7.

    CAS  PubMed  Google Scholar 

  69. McAdoo WG, Weinberger MH, Miller JZ, Fineberg NS, Grim CE. Race and gender influence hemodynamic responses to psychological and physical stimuli. J Hypertens. 1990;8(10):961–7.

    CAS  PubMed  Google Scholar 

  70. Baldwin R, Jeffries S, Jackson A, Sutcliffe C, Thacker N, Scott M, et al. Neurological findings in late-onset depressive disorder: comparison of individuals with and without depression. Br J Psychiatry. 2005;186:308–13.

    PubMed  Google Scholar 

  71. Veldhuijzen van Zanten JJ, Kitas GD. Inflammation, carotid intima-media thickness and atherosclerosis in rheumatoid arthritis. Arthritis Res Ther. 2008;10(1):102.

    PubMed  Google Scholar 

  72. Oparil S, Zaman MA, Calhoun DA. Pathogenesis of hypertension. Ann Intern Med. 2003;139(9):761–76.

    CAS  PubMed  Google Scholar 

  73. Matthews KA, Katholi CR, McCreath H, Whooley MA, Williams DR, Zhu S, et al. Blood pressure reactivity to psychological stress predicts hypertension in the CARDIA study. Circulation. 2004;110(1):74–8.

    PubMed  Google Scholar 

  74. McEwen BS. Stress, adaptation, and disease. Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44.

    CAS  PubMed  Google Scholar 

  75. Paterniti S, Zureik M, Ducimetière P, Touboul PJ, Fève JM, Alpérovitch A. Sustained anxiety and 4-year progression of carotid atherosclerosis. Arterioscler Thromb Vasc Biol. 2001;21(1):136–41.

    CAS  PubMed  Google Scholar 

  76. Haas DC, Davidson KW, Schwartz DJ, Rieckmann N, Roman MJ, Pickering TG, et al. Depressive symptoms are independently predictive of carotid atherosclerosis. Am J Cardiol. 2005;95(4):547–50.

    PubMed  Google Scholar 

  77. Lynch J, Kaplan GA, Salonen R, Cohen RD, Salonen JT. Socioeconomic status and carotid atherosclerosis. Circulation. 1995;92(7):1786–92.

    CAS  PubMed  Google Scholar 

  78. Barnett PA, Spence JD, Manuck SB, Jennings JR. Psychological stress and the progression of carotid artery disease. J Hypertens. 1997;15(1):49–55.

    CAS  PubMed  Google Scholar 

  79. Matthews KA, Owens JF, Kuller LH, Sutton-Tyrrell K, Lassila HC, Wolfson SK. Stress-induced pulse pressure change predicts women’s carotid atherosclerosis. Stroke. 1998;29(8):1525–30.

    CAS  PubMed  Google Scholar 

  80. Kamarck TW, Everson SA, Kaplan GA, Manuck SB, Jennings JR, Salonen R, et al. Exaggerated blood pressure responses during mental stress are associated with enhanced carotid atherosclerosis in middle-aged Finnish men: findings from the Kuopio ischemic heart disease study. Circulation. 1997;96(11):3842–8.

    CAS  PubMed  Google Scholar 

  81. Jennings JR, Kamarck TW, Everson-Rose SA, Kaplan GA, Manuck SB, Salonen JT. Exaggerated blood pressure responses during mental stress are prospectively related to enhanced carotid atherosclerosis in middle-aged Finnish men. Circulation. 2004;110(15):2198–203.

    PubMed  Google Scholar 

  82. Steptoe A, Donald AE, O’Donnell K, Marmot M, Deanfield JE. Delayed blood pressure recovery after psychological stress is associated with carotid intima-media thickness: Whitehall psychobiology study. Arterioscler Thromb Vasc Biol. 2006;26(11):2547–51.

    CAS  PubMed  Google Scholar 

  83. Holowatz LA, Thompson-Torgerson CS, Kenney WL. The human cutaneous circulation as a model of generalized microvascular function. J Appl Physiol (1985). 2008;105(1):370–2.

    Google Scholar 

  84. Rozanski A, Bairey CN, Krantz DS, Friedman J, Resser KJ, Morell M, et al. Mental stress and the induction of silent myocardial ischemia in patients with coronary artery disease. N Engl J Med. 1988;318(16):1005–12.

    CAS  PubMed  Google Scholar 

  85. Soufer R, Burg MM. The heart-brain interaction during emotionally provoked myocardial ischemia: implications of cortical hyperactivation in CAD and gender interactions. Cleve Clin J Med. 2007;74(Suppl 1):S59–62.

    PubMed  Google Scholar 

  86. Lampert R, Jain D, Burg MM, Batsford WP, McPherson CA. Destabilizing effects of mental stress on ventricular arrhythmias in patients with implantable cardioverter-defibrillators. Circulation. 2000;101(2):158–64.

    CAS  PubMed  Google Scholar 

  87. Soufer R, Fernandez AB, Meadows J, Collins D, Burg MM. Body mass index and risk for mental stress induced ischemia in coronary artery disease. Mol Med. 2016;22:286–91.

    CAS  PubMed  Google Scholar 

  88. Blumenthal JA, Jiang W, Waugh RA, Frid DJ, Morris JJ, Coleman RE, et al. Mental stress-induced ischemia in the laboratory and ambulatory ischemia during daily life. Association and hemodynamic features. Circulation. 1995;92(8):2102–8.

    CAS  PubMed  Google Scholar 

  89. Golding M, Kotlyar M, Carson SW, Hoyler S, Lazarus C, Davidson C, et al. Effects of paroxetine on cardiovascular response to mental stress in subjects with a history of coronary artery disease and no psychiatric diagnoses. Psychopharmacology. 2005;182(3):321–6.

    CAS  PubMed  Google Scholar 

  90. Yeung AC, Vekshtein VI, Krantz DS, Vita JA, Ryan TJ Jr, Ganz P, et al. The effect of atherosclerosis on the vasomotor response of coronary arteries to mental stress. N Engl J Med. 1991;325(22):1551–6.

    CAS  PubMed  Google Scholar 

  91. Dakak N, Quyyumi AA, Eisenhofer G, Goldstein DS, Cannon RO III. Sympathetically mediated effects of mental stress on the cardiac microcirculation of patients with coronary artery disease. Am J Cardiol. 1995;76(3):125–30.

    CAS  PubMed  Google Scholar 

  92. Arrighi JA, Burg M, Cohen IS, Kao AH, Pfau S, Caulin-Glaser T, et al. Myocardial blood-flow response during mental stress in patients with coronary artery disease. Lancet. 2000;356(9226):310–1.

    CAS  PubMed  Google Scholar 

  93. Fontana F, Bernardi P, Lanfranchi G, Conti E, Spampinato S, di Toro R, et al. Endothelin-1 response to mental stress in early ischemic lesions of the extremities due to systemic sclerosis. Peptides. 2005;26(12):2487–90.

    CAS  PubMed  Google Scholar 

  94. Wilson LM, Baldwin AL. Effects of environmental stress on the architecture and permeability of the rat mesenteric microvasculature. Microcirculation. 1998;5(4):299–308.

    CAS  PubMed  Google Scholar 

  95. Czeh B, et al. Quantitative changes in hippocampal microvasculature of chronically stressed rats: no effect of fluoxetine treatment. Hippocampus. 2010;20(1):174–85.

    PubMed  Google Scholar 

  96. Maingrette F, Dussault S, Dhahri W, Desjarlais M, Mathieu R, Turgeon J, et al. Psychological stress impairs ischemia-induced neovascularization: protective effect of fluoxetine. Atherosclerosis. 2015;241(2):569–78.

    CAS  PubMed  Google Scholar 

  97. Waldstein SR, Siegel EL, Lefkowitz D, Maier KJ, Pelletier Brown JR, Obuchowski AM, et al. Stress-induced blood pressure reactivity and silent cerebrovascular disease. Stroke. 2004;35(6):1294–8.

    PubMed  Google Scholar 

  98. van Agtmaal MJM, Houben AJHM, Pouwer F, Stehouwer CDA, Schram MT. Association of microvascular dysfunction with late-life depression: a systematic review and meta-analysis. JAMA Psychiatry. 2017;74(7):729–39.

    PubMed  Google Scholar 

  99. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99(16):2192–217 Comprehensive review regarding the cardiovascular effects of acute and chronic stress including an overview of psychosocial factors, vascular biology, the role of the autonomic nervous system, and clinical syndromes.

    CAS  PubMed  Google Scholar 

  100. Das S, O'Keefe JH. Behavioral cardiology: recognizing and addressing the profound impact of psychosocial stress on cardiovascular health. Curr Atheroscler Rep. 2006;8(2):111–8.

    PubMed  Google Scholar 

  101. Dimsdale JE. Psychological stress and cardiovascular disease. J Am Coll Cardiol. 2008;51(13):1237–46.

    PubMed  Google Scholar 

Download references

Funding

This work was supported by NIH NHLBI R01 HL059619 and R01 HL071116, awarded to RS and MB.

Author information

Authors and Affiliations

  1. Section of Cardiovascular Medicine, Yale School of Medicine, 950 Campbell Ave./111B, West Haven, CT, 06516, USA

    Samit M. Shah, Judith L. Meadows, Matthew M. Burg, Steven Pfau & Robert Soufer

  2. VA Connecticut Healthcare System, West Haven, CT, USA

    Samit M. Shah, Judith L. Meadows, Matthew M. Burg, Steven Pfau & Robert Soufer

Authors
  1. Samit M. Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Judith L. Meadows
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Matthew M. Burg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Steven Pfau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert Soufer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert Soufer.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Nuclear Cardiology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shah, S.M., Meadows, J.L., Burg, M.M. et al. Effects of Psychological Stress on Vascular Physiology: Beyond the Current Imaging Signal. Curr Cardiol Rep 22, 156 (2020). https://doi.org/10.1007/s11886-020-01406-x

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11886-020-01406-x

Keywords

Search

Navigation